ABSTRACT
Traumatic brain injury (TBI) is a serious disorder that is all too common. TBI ranges in severity from mild concussion to a severe life-threatening state. Across this spectrum, rational therapeutic approaches exist. Early identification that TBI has occurred in a patient is paramount to optimal outcome. Proper clinical management should be instituted as soon as possible by appropriately trained medical providers. More seriously injured patients must be triaged to advanced care centers. It is only through this rational approach to TBI that patients may expect to achieve optimal clinical and functional outcome.
Subject(s)
Brain Injuries/therapy , Critical Care/methods , Brain Injuries/physiopathology , Early Diagnosis , Humans , Practice Guidelines as Topic , Treatment OutcomeABSTRACT
OBJECTIVE: A cavum septum pellucidum is an anatomical variant that is usually considered an incidental finding of little clinical significance. This is a fluid-containing structure between the lateral ventricles whose walls exhibit lateral bowing and are 10-mm apart or greater. It has been hypothesized that enlarged cysts of this type may cause hydrocephalus and resultant headache (HA), but there have been very few reports in the literature and even fewer reports of successful treatments. METHODS: We describe a patient with subacute onset of positional HA who was found to have a large dilated cavum cyst on magnetic resonance imaging. RESULTS: The patient underwent endoscopic fenestration of the cyst, which eradicated his HAs. CONCLUSIONS: We hypothesize that this patient's large cavum septum pellucidum cyst was causing intermittent, positional hydrocephalus and thus HAs. This is a very unusual but highly treatable cause of positional HA that could be overlooked easily.
